5 factors you should consider while buying the best health insurance plan in India

#1. Claim Settlement Ratio (CSR): It is the ratio of the total number of claims settled by the insurance company to the total number of claims received in the same duration of time.

Expert tip: A high CSR indicates that the company is more likely to settle a claim without any hassles.

#2. Incurred Claim Ratio (ICR): It is the ratio of the total amount of all claims received by a company to the total premiums collected in the same duration of time. A high ICR indicates that an insurance company is more likely to accept new customers, more likely to have the less waiting period for pre-existing illnesses, and more likely to issue policies to people with pre-existing illnesses.

#3. Network Hospitals: An insurer should have a good number of hospitals in its network in each city, which cater to various classes of people. The network hospitals should include nursing homes, day-care centre, and multi-speciality hospitals.

#4. Waiting Period for pre-existing illnesses: This is one of the most important factors as a longer waiting period for pre-existing illnesses can mean that you cannot make a claim for hospitalization, even though you are paying the premium.

Expert Finding: 2 years is the waiting period for pre-existing illness to be covered. However, there are some insurers who specify the waiting period to be 4 years also.

#5. Cost of Premiums: The premiums no doubt varies across insurers but what matters is what we are going to get for the premium we pay. The premium should cover a fairly acceptable room rent in any city, medical and surgical costs and also cover common treatment costs such as cataract, knee surgery, dialysis etc.

The insurer should have different types of plan available that is suitable for different sections of people such as individual health plans, family floater plans, senior citizen health plans, top-up plans and plans suitable for people with certain health conditions such as cancer and heart disease.

5 Best Health Insurance Companies in India

Let’s see what fits into our requirements from the list of best health insurance companies in India.

#1. Max Bupa

Max bupa insurance offers coverage for a number of illnesses, access to hospital networks and cashless claims.

Claim settlement ratio of Max Bupa is 91.2% and a high ICR of 51.96%. Max has over 3000 hospitals in its network.

#2. Apollo Munich

Apollo Munich is a stand-alone health insurance company that offers policies for both individuals and families needs.

Claim settlement ratio of Apollo is 98.18% and an ICR of 54.99%. That means the company is highly likely to settle your claim and also highly likely to issue policies to new customers.

#3. ICICI Lombard

ICICI Lombard has a network of 4500+ hospitals to avail cashless facilities.

According to IRDA, it is supposed to have settled 98.32% of the claims received. It has a very high ICR of 80.38% which indicates that people are renewing the policy and also making claims.

#4. Star Health Insurance

Star Health Insurance company provides a wide range of health insurance policies for individuals, families, senior citizens and for those who need specialized care like heart patients and cancer patients.

Star has a high claims settlement percentage of 98.72% and ICR of 60.51% with a whopping 8200+ hospitals are on its network.

#5. CIGNA TTK

Cigna is a multi-national insurer and partnering with TTK in India.

Cigna TTK has settled 98.22% of its claims and has an ICR of 48.14%. Because of its international presence, the insured can get hospitalized abroad and claim to the policy purchased in India.

There are many types of health policies issued by these companies and we have to choose one depending on our requirements. Let us look at the typical categories of health policies that are available in the market.

5 Type of Health Insurance Policies in India

#1. Individual health plans

If you have an individual health insurance policy, you alone will be eligible to claim the benefit of the entire sum assured and also, all the benefits covered in the plan and it cannot be transferred to anyone.

The greatest advantages of individual health plans are

Offers higher protection for each person rather than as a family.

The policy can be renewed without any age restrictions.

Suitable for people with health risks.

No risk for other family members even if the cover gets exhausted in a single year.

#2. Family floater health insurance policies

Family floater health policies are umbrella health cover tailored for the entire family. A single premium is paid to obtain a cumulative health cover for the entire family and the amount of health coverage can be utilized for hospitalization expenses of any member of the family.

The advantage of family floater insurance policy is that

You can get your entire family covered by health insurance at a lesser cost.

You can cover 4 children for each policy along with 2 adults.

The biggest disadvantage of family floater health policy is that

There is a high possibility of the entire cover getting exhausted due to the hospitalization of one family member.

If your family members have frequent illness then opt for individual plans.

#3. Senior citizen health insurance policies

Buying health insurance at an old age is difficult or unaffordable. I suggest you buying the health insurance policy for your parents before they get too old.

The Senior citizen policies are similar to individual health policies but come with stringent medical checkups, high premiums, the higher waiting periodfor pre-existing illnesses and a greater number of exclusion clauses.

These policies are usually bought by people who have already crossed 60 years of age but did not have any health insurance until then.

#4. Top-up and super top-up insurance policies

Top-up and super top-up policies are health policies which come with a ‘deductible’ clause. These policies come into effect after the amount specified as the deductible is incurred as hospitalization expenses.

For example, assume that you have bought a top-up/super top-up policy of Rs.20 lakhs with a deductible of Rs.5 lakhs. If you get hospitalized, you are eligible to claim from the top-up/super top-up policy for all your hospitalization expenses over Rs. 5 lakhs.

The biggest advantage of these policies is that you can get a large cover for a low premium. Even though there is a deductible clause applicable, you can take a basic health policy whose sum assured will be equal to the deductible.

The biggest advantage is that these policies cover illnesses like heart disease or cancer, which are usually avoided by many insurers. The premiums for such policies are high as the risk is high for the insurer.

These policies are designed for people who are already diagnosed with certain diseases or are at high risk of getting certain diseases.

Don’t rely on employer-provided health insurance

One of the main reasons why people avoid taking health covers is because of employer-provided group health coverage. But no matter how much health cover your employer provides, it has its own drawbacks.

Let’s understand why having your own health coverage is important.

Employer-provided insurance benefits will end the moment you leave or change the job.

You can not carry forward the benefits of employer health insurance.

Having your own health cover early in life will always help in the case, you are diagnosed with any illness. This is because the waiting period clause will not apply and any illnesses you catch at a later stage gets covered.

Employer-provided insurance clauses can change any time.

Employer-provided health coverage can exhaust in a single hospitalisation. You must have a backup policy.

Would you buy an expensive health cover post-retirement?

13 Practical tips to choose the best health insurance policy

Tip #1.

Always buy an individual policy at a young age. Otherwise, insurance becomes expensive as you grow old.

Tip #2.

Choose the right amount of sum insured as per your family size. Smokers, obese individuals and people with inactive lifestyles have higher health risks and need higher cover.

Tip #3.

If you are buying health coverage for a family of 4 (2 adults and 2 kids), you can either

Buy individual covers for each family members and buy an additional family floater to increase the cover.

The second option is to buy a family floater and then buy a top-up/super top-up policy whose deductible is equal to the sum insured of the family floater policy.

Tip #4.

Choose a policy with minimal exclusions. Buy a plan which covers 100% of the costs of hospitalization, common day care procedures and a part of pre and post-hospitalization costs. Do not opt for plans which have co-pay option.

Tip #5.

Choose a policy which offers lifetime renewability.

Tip #6.

Do not buy a policy which has sub-limits on per day expenses or room rent

Tip #7.

Your health plan should cover hospitalization expenses for critical illnesses also. There should be no “claim loading” in case you or your family are diagnosed with critical illness. Claim loading is a feature in which the insurance company can keep increasing your premiums year on year if you are diagnosed with critical illness.

Tip #8.

Check the waiting periodfor pre-existing illnesses. Most insurance policies have 2 years as the waiting period but some have up to 4 years.

Tip #9.

Check the clauses for getting treated at network and non-network hospitals. Many insurers reimburse only 70-80% of the costs if you get treated at a non-network hospital.

Tip #10.

If you are buying health cover for aged parents, check the list of illnesses and medical procedures that are not covered. Your policy should provide cover for common surgeries required by aged people such as cataract and knee surgery.

Tip #11.

Buy the policy before you get any critical disease (health, lungs, cancer). Many policies have clear-cut clauses that the policies are to be bought before the onset of any such illness.

Tip #12.

Buy a top-up/super top-up policy at a very less premium to get a large cover if you want to increase your health cover.

Tip #13.

Buy separate individual policies for yourself and your spouse as you grow old. This is an important step because family floater policies are issued against the name of the oldest person listed in the group. If the oldest person passes away, the policy ceases and the remaining family members have to buy a new policy at higher premium rates.

Before we look at the best health insurance policies, let us understand some of the common terms used to describe the features, benefits and advantages of health policies.

Glossary

AYUSH : It stands for AYurvedic, Unani, Siddha and Homeopathy. If a health insurance policy provides coverage for AYUSH treatments, it means that the insured can undergo treatments suggested by the AYUSH doctors and make a claim for it.

Restoration Benefit: It is a benefit that allows an insured to reinstate (refill) the entire sum insured in the policy year when it gets exhausted due to incurred claims. You can reinstate up to 100% of the sum insured in a year. But it costs slightly more than a standard health insurance.

Daycare Procedures: A day care procedure is a surgery or medical procedure that formerly required a prolonged stay in hospital but can now be completed in less than 24 hours.

Domiciliary Hospitalization: It means medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a Hospital but actually taken while confined at home under any of the following circumstances, namely:

i) The condition of the patient is such that he/she cannot be removed to the Hospital/Nursing Home or

ii) The patient cannot be removed to Hospital/Nursing Home for lack of accommodation therein.

Best Family Floater Health Insurance Plans in India

#1. Apollo Munich Optima Restore

This policy is specially designed for family needs and offers cover for spouse, children, parents, and parents-in-law.

This cover automatically restores the basic sum assured if it gets exhausted within a policy year, at no extra cost. However, the restores sum insured can be utilized only for claims of the hospitalized person within that policy year.

Also, if you do not make any claim for 2 consecutive years, the Sum Insured gets doubled.

Features & Benefits

Minimum Age for cover

91 days to 65 years

Maximum Age for Renewal

Lifelong

Waiting Period to cover pre-existing illness

36 months

No-Claim Benefits

If you do not claim for 2 consecutive years, your Sum Insured will be doubled.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 90 days prior to hospitalization is covered.

Restoration Benefit

Expenses for consultation, medical tests, and medicines incurred up to 180 after discharge is covered.

Day Care Procedures

A total of 144 daycare procedures are covered.

Domiciliary Hospitalization

Treatment at home can be availed subject to certain terms and conditions.

Cover for the medical expenses for harvesting the organ from the donor for transplantation up to a limit of sum insured.

Allows a complimentary health check-up for a block of 2 policy years up to a maximum of Rs.10,000 depending on the sum insured.

Ambulance charges of up to Rs.2000 is covered.

Stay Active Benefit – You can download their app to count the number of steps you take each day and avail up to 8% discount on the premium.

Free second e-opinion from doctors recognized by Apollo in case of diagnosis of critical illnesses.

Allows you to include in-laws in the family cover.

Daily cash benefit of Rs.800 or Rs.1000 is given if you choose a shared hospital room.

Disadvantages

If the age of the policyholder or the eldest member of the policy is above 61 years, you have to bear 20% co-payment charges at the time of claim.

No cover for AYUSH treatments.

Higher waiting period of 3 years for pre-existing illness.

No maternity benefits.

#2.Max Bupa Heartbeat Family Floater Health Insurance Plan

It is a comprehensive health insurance best-suited to a family’s needs.

There are 3 variants in this plan – Silver, Gold, and Platinum.

Silver variant – It is a basic health insurance plan which covers inpatient care, pre and post hospitalization expenses and day care procedures. It also offers maternity benefits for 2 kids and covers the newborn baby also.

Gold variant – This has all features of Silver plan and an additional feature of cover for AYUSH treatments.

Platinum variant – This variant offers all features of Gold plan and has many additional features as below:

No limit on hospital room category.

Covers international treatment for specified illnesses like cancer.

Charges for OPD treatment and diagnostic services if required.

Option to carry forward the sub-limit for consultation and diagnostic services to the next policy year.

Vaccination expenses for children up to the age of 12 years.

Features

Minimum Age for cover

No entry age specified. Newborn to senior citizen can be covered in the same policy.

Maximum Age for Renewal

Lifelong renewal is allowed.

Waiting Period to cover pre-existing illness

2 years for gold and platinum variants and 4 years for silver variant.

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 50% of the Sum Insured.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 90 days prior to hospitalization is covered.

Restoration Benefit

No Available

Day Care Procedures

All daycare procedures are covered provided the procedure is not carried out in the OPD or the diagnostic services of the hospital.

Domiciliary Hospitalization

Provided only if there is no bed available in the hospital and a minimum of 3 days treatment is taken at home.

19 different relations including spouse, children, parents, parents-in-law, dependent brothers, dependent sisters are allowed to be covered in the policy.

Maternity Benefits for delivery of up to 2 children.

A newborn is covered immediately without any additional premium.

Free Health check-up every 2 years if the policy is renewed regularly.

Vaccination expenses are covered in the Platinum plan

International treatment is covered in the platinum plan. Also, sub-limit for OPD and diagnostic services expenses are available and can also be carried forward to the next policy year.

AYUSH treatments are covered for both Gold and Platinum plans.

Disadvantages

Waiting period for pre-existing illness is 2 years for Gold and Platinum plan but 4 years for the basic Silver plan.

No restoration benefits.

#3. Bajaj Allianz Health Guard Family Floater Plan

This is a comprehensive policy which covers your entire family on a floater basis i.e. the Sum Insured can be used to meet hospitalization or other permitted expenses for any of the insured member under the policy.

Though the policy has co-pay clause(in which you have to pay a part payment of hospital bill) after certain years of age. The biggest advantage of this policy is that the common surgeries that are carried out for aged-people such as cataract, joint replacement, etc. are covered after a waiting period of 4 years.

Features

Minimum Age for cover

3 months to 65 years

Maximum Age for Renewal

Up to 80 years of age

Waiting Period to cover pre-existing illness

4 years

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 50% of the Sum Insured.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 90 days prior to hospitalization is covered.

Value-added services like a discount on OPD consultations and diagnostic services at select outlets.

Complimentary health checkup for every 4 continuous policy years.

Surgeries such as joint replacement, cataract, hernia, and pile are all covered after a waiting period of 2 years or 4 years as specified in the policy.

Known for smooth and quick processing of claims.

Disadvantages

10% co-pay applicable if treated in a non-network hospital.

20% co-pay is applicable for every hospitalization after 56 years of age.

AYUSH treatments not covered.

Domiciliary treatment not allowed.

Restoration Benefit not available.

Best Health Insurance in India for Individual

#4. Apollo Munich Easy Health Individual Plan

This is an individual health plan which offers in-patient cover, pre and post hospitalization expenses cover along with AYUSH treatment cover.

The policy provides an option to purchase a Critical Illness Rider. If you purchase the Critical Illness Cover, then a Critical Illness cover which is equal to either 50% or 100% of the Sum Insured is given. The minimum Critical Illness Cover you have to purchase is Rs.1 lakh.

There are 3 variants in this – Standard, Exclusive and Premium.

Standard Plan – This includes cover for in-patient expenses, pre and post hospitalization expenses, daycare cover, domiciliary treatment cover, and organ transplant cover. It also includes a Rs.20000 cover for AYUSH treatment. If you opt for shared accommodation during hospitalization, you can claim a cash benefit of Rs.500 per day.

Exclusive Plan – This includes all the features of Standard plan with some additional features like

AYUSH treatment cover of Rs.25000.

Hospital cash benefit between Rs.500 – Rs.1000 per day depending on the Sum Insured.

Hospital benefit for accompanying an insured child between Rs.300 – Rs.800 per day depending on the Sum Insured.

Maternity Benefit of Rs.15000 for normal delivery and Rs.25000 for Caesarean delivery.

Premium Plan – This plan includes all the features of Exclusive plan with the following additional benefits:

Spectacle, contact lens, and hearing aid charges are covered between a limit of Rs.5000 – Rs.7500 every third year.

Entitled to a second e-opinion by an Apollo empaneled doctor in case of diagnosis of critical illness.

Dental treatments to a maximum of Rs.7500 is covered.

Features

Minimum Age for cover

3 months to 65 years

Maximum Age for Renewal

Up to 80 years of age

Waiting Period to cover pre-existing illness

3 years

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 100% of the Sum Insured. However, the Cumulative Bonus is reduced by 10% of Sum Insured once a claim is made.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 90 days prior to hospitalization is covered.

Restoration Benefit

Not available

Day Care Procedures

144 types of daycare procedures covered.

Domiciliary Hospitalization

Provided only if a minimum of 3 days treatment is taken at home.

Alternative Treatments – AYUSH

Rs.20,000 for Standard Plan and between Rs.25000 – Rs.50000 for Exclusive and Premium plans depending on the Sum Insured.

Reimbursement up to the Sum Insured in case you have to be hospitalized in other countries.

Maternity coverage up to Rs. 15,000 for normal delivery and Rs. 25,000 for a C-section after a waiting period of 2 years.

Reimbursement of Rs.2000 fixed cost per year for OPD consultations, medicines and diagnostic tests.

Free comprehensive health checkup at every renewal.

Add on benefits such as voluntary co-pay benefit, deductible option, and critical illness cover are available.

Disadvantages

AYUSH treatments not covered.

#6. HDFC Ergo Health Suraksha – Regain Benefit Plan

It is an individual plan with affordable premium rates as compared to the other plans in this list. It offers restoration benefit in case the Sum Insured gets exhausted in a policy year.

They have a large network of 6000+ hospitals in which you can claim cashless benefits.

Features

Minimum Age for cover

91 days onwards

Maximum Age for Renewal

Lifelong renewable

Waiting Period to cover pre-existing illness

2 years

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 100% of the Sum Insured. However, the Cumulative Bonus is reduced by 10% of Sum Insured once a claim is made.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 90 days prior to hospitalization is covered.

Restoration Benefit

Basic Sum Insured will be reinstated only once in a policy year. It will be applicable for future hospitalization for an illness that has not been already claimed in the current policy year.

Day Care Procedures

144 types of daycare procedures covered.

Domiciliary Hospitalization

If you need to be treated at home due to a bed shortage at the hospital or even if your doctor prescribed home care, it will be covered up to the sum insured.

Alternative Treatments – AYUSH

Covered without any sub-limit

Exclusions

Attempted suicide, pregnancy, childbirth, IVF treatment, and AIDS

Advantages

Organ transplant costs including donor hospitalization is covered.

Complete cover for AYUSH treatments without any sub-limit.

Maternity coverage up to Rs. 15,000 for normal delivery and Rs. 25,000 for a C-section after a waiting period of 2 years.

Waiting period of 2 years apply for common surgeries like gallstone and kidney stone removal, tonsillitis, stomach ulcer etc.

Top Up/Super Top Up Health Insurance Policy

#7. ICICI Health Booster Super Top Up Policy

This is a super top-up policy which is very similar to other health insurance policies except that it comes with a deductible amount. The greatest advantage of such policies is getting high health cover at a low premium.

With this policy you have to bear the hospitalization expenses which is equal to the deductible amount. All hospitalization expenses over above the deductible amount will be covered by this policy.

For example, you have bought this policy with a Sum Insured of Rs.10 lakhs and a deductible of Rs.3 lakhs. Assume you get hospitalized and the total expenses are Rs.5 lakhs. Since the deductible is Rs. 3 lakhs, you have to bear the expense of Rs.3 lakhs and the policy will give you Rs. 2 lakhs.

It is important to note that you need not have to bear the deductible amount from your pocket. If you have an individual or family floater policy, it can be used to pay the deductible amount.

So, super top up policy is good in case you already have a health insurance policy and you want to increase the sum assured but at lesser cost.

Features

Minimum Age for cover

91 days onwards

Maximum Age for Renewal

Lifelong renewable

Waiting Period to cover pre-existing illness

2 years

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 50% of the Sum Insured. However, the Cumulative Bonus is reduced by 10% of Sum Insured once a claim is made.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 90 days prior to hospitalization is covered.

Restoration Benefit

Basic Sum Insured will be reinstated only once in a policy year. It will be applicable for future hospitalization for an illness that has not been already claimed in the current policy year.

Day Care Procedures

150 types of daycare procedures covered.

Domiciliary Hospitalization

If you need to be treated at home due to a bed shortage at the hospital or even if your doctor prescribed home care, it will be covered up to the sum insured.

Alternative Treatments – AYUSH

Covered without any sub-limit

Exclusions

Attempted suicide, pregnancy, childbirth, IVF treatment, and AIDS

Advantages

Deductible applicable on aggregate basis per policy year.

Complimentary health check coupons are issued every year.

Tax benefits can be claimed under Section 80D just like other health insurance plans.

Organ transplant costs including donor hospitalization is covered.

AYUSH treatment is covered without any sub-limit.

Can be bought as an individual or family floater policy.

Disadvantages

Once the insured crosses 60 years of age, 20% of the amount above deductible is applicable for every claim as co-payment.

Best Health Insurance Plan for Parents (Senior Citizen)

#8. Star Senior Citizen Red Carpet

This a is policy exclusively for senior citizens. Anyone above 60 years of age and up to 75 years can buy this policy, and the cover will be renewable lifelong.

This is available as an individual policy only.

Features

Minimum Age for cover

60 years up to a maximum of 75 years

Maximum Age for Renewal

Lifelong renewable

Waiting Period to cover pre-existing illness

12 months

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 50% of the Sum Insured. However, the Cumulative Bonus is reduced by 10% of Sum Insured once a claim is made.

Pre-hospitalization

Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.

Post-hospitalization

A sum equivalent to 7% of the hospitalization expenses incurred comprising of Nursing Charges, Surgeon / Consultant fees, Diagnostic charges, Medicines and drugs only subject to a maximum of Rs.5,000/- per occurrence.

Restoration Benefit

Basic Sum Insured will be reinstated only once in a policy year. It will be applicable for future hospitalization for an illness that has not been already claimed in the current policy year.

Room, Boarding and nursing expenses as provided by the Hospital / Nursing Home at 1% of the sum insured subject to a maximum of Rs.6,000/- per day.

ICU charges up to 2% of the Sum Insured per day.

Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees subject to a maximum of 25% of the sum insured per hospitalization.

#9. Bajaj Silver Health

This policy can be bought by anyone who is between the age of 46-70 years of age and can be renewed lifelong.

This is available as an individual policy only.

Features

Minimum Age for cover

46 years up to a maximum of 70 years

Maximum Age for Renewal

Lifelong renewable

Waiting Period to cover pre-existing illness

12 months

No-Claim Benefits

For every claim free year, you will get 10% per annum increase in the Sum Insured, up to a maximum of 50% of the Sum Insured. However, the Cumulative Bonus is reduced by 10% of Sum Insured once a claim is made.

Pre-existing ailments related to cardiac care are covered after 3 months from the purchase of the policy.

Disadvantages

Co-pay of 10% of each claim of the insured beyond 60 years of age.

Cap on the Room, boarding, nursing expenses as provided by the Hospital / Nursing Home at 2% of the sum insured, subject to a maximum of Rs.5,000/- per day.

AYUSH treatments not covered.

Organ transplant costs are not covered.

Things you should know about health insurance

It is always better to buy from a reputed insurance broker. Verify the credentials of the insurance agent before you buy a health policy. If any claims get rejected, your agent may not be able to help you.

You can also buy health policies online at lesser price than Offline. You have to make sure that you declare all the requested data correctly and honestly.

You can actually bargain for less premium rates if you have healthy living habits such as maintaining good BMI, exercising regularly, avoiding smoking etc.

No insurer will provide cover for a person aged above 90 years. Any existing policies also cease to be effective once the insured crosses 90 years of age. This applies to employer-provided health insurance for retirees also.

The family floater policies are issued with the eldest member as the policyholder. If the eldest in the family deceases, a fresh policy has to be taken by the surviving family members at prevailing premium rates.

Always declare every detail of your illness, if any, even if it seems insignificant. Insurers have experts to determine if you have not declared any pre-existing illness and may deny your claims.

If you are not satisfied with your existing health insurance policy, you can always ‘port-out’ to another policy. However, you have to pay the applicable premium of the new policy. But the greatest advantage is that the waiting period for the pre-existing illness will not apply.

Final Words

As you can gauge by now, yours and your family’s health insurance needs will be unique. You have to choose a policy based on various factors such as sum insured, co-pay and sub-limit clauses, network hospitals, etc., and not just about quoting low premiums.

Always buy a health policy early in life as it works out cheaper and also, you will be on safer side if you get any illness later in life.

Reader Interactions

Comments

Thank you pardeep for such this Wonderful article. I was so confused searching internet for health insurance and I couldn’t make my mind whom to select or not. You have compiled all the major points that should be considered. This made me easy to understand the concept of health insurance even when I had no knowledge of this. Thanks again

There are policies like Max Bupa Go Active, which includes further additions and benefits for maintaining healthy lifestyles but also charges higher charges. I want to understand if they can be benficial or like term insurance the pure health claim only is better.?

hi pradeep, this is amirtharaj from Bahrain. i was thinking for health insurance taken in india for me & my family longtime. i was so confused which one to choose. here in bahrain i have only myself medical insurance provided by my employer. here medical insurance concept entirely different, this means when you have medical insurance card you can directly go network hospital and just to pay initial amount of BD 3/5/7 based on your card mentioned (1 BD=INR 190/approx) that is it. after that all the test/medicine/consultation everything is free of cost with unlimited time up to covered sum insured. where as in india not like that. after i read your article i understood it is entirely different from bahrain health insurance policy. i really appreciate that your effort and good work. thanks for your such a wonderful and most important article.

Hi Pardeep, Your article is extremely helpful to everyone struggling to understand the advantages and disadvantages of various policies. Specifically for me it has really helped to take an informed decision in buying a policy for my family. Greatly appreciate your valuable insights.

Hi Pradeep, Great article.My research regarding the best health insurance started by reading this article. Later I came to a conclusion that Max bupa health companion and Apollo Munich optima restore are the best two family floater policies(both do not have maternity cover).

Why didn’t you shortlist Max Bupa health companion ? Some its features are given below(which optima restore do not have) -You can opt for hospital cash without room sharing for a premium equivalent to that of optima restore. -AYUSH treatment covered -Health checkup in every year from second year onwards -Non deductible no claim bonus of 20% (NCB will not loose if you make a claim in the following years)

The biggest advantage of optima restore is you can use the restoration amount for the same/related illness. No other company permits that. So a 5Lack policy is actually giving protection for 10Lacks without any terms and conditions.